Chris J. Hanson was preparing to leave his beachfront hotel on the last day of vacation when his mind started malfunctioning in a rare and mysterious way.
As he put on a shirt, he told his wife, Bobbi-Jo, that he wished they’d spent more time on the balcony. She was puzzled. He’d just been on the balcony, and they had eaten several meals there.
“I don’t want to scare you,” he told her, “but I don’t remember any of that.”
He did scare her. Afraid he was having a stroke, she rushed him to a Miami hospital. Every 15 seconds or so, he’d ask the same questions. “Where am I?” “Where’s my phone?” “Where’s my wallet?” He remembered who he was. He remembered Bobbi-Jo and their kids. But the last six months were a blank, and he wasn’t making any new memories.
He teared up when Bobbi-Jo reminded him that he had bought tickets to an Ultimate Fighting Championship event when they returned home to Colorado Springs. He didn’t remember that, either, a sign that something was very wrong.
Eight hours later, a doctor asked whether Hanson knew why he was in the hospital. For the first time, he said yes. A few minutes later, the doctor asked again. Hanson not only remembered why he was there, he remembered that the doctor had asked before. His earlier memories came back just as suddenly as they had vanished, but Hanson, now 51, still doesn’t remember what happened during those eight hours.
He had a classic case of transient global amnesia (TGA), an enigmatic form of memory loss that doctors still can’t explain 65 years after it was first described. It was unusual enough — about five to 10 of every 100,000 people are diagnosed with it each year — that Hanson’s doctor brought some younger colleagues to crowd around Hanson’s bed and ask him questions. “They were extremely fascinated,” Hanson said. Doctors will tell you that it is rarely good to be a fascinating patient.
Transient global amnesia, though, is an exception to that rule, which is one of the things that neurologists like about it.
“I don’t have bad news for these patients, and neurologists often have bad news,” said Nathan Young, a Mayo Clinic neurologist.
TGA does not seem to be a harbinger of worse things to come, and only 5% to 15% of patients have a second episode, said Young, who has studied recurrent cases. The bad news is that it’s still very distressing for patients and families.
“It’s always a frightening, disturbing event,” Young said.
Among the potential triggers are stress and strong emotions. A recent study from a German academic medical center found an increase in transient amnesia cases in the early days of the COVID-19 pandemic. The researchers thought stress might be to blame. Between Feb. 1 and May 15, 2020, the hospital saw 16 patients with the condition compared with an average of 9.7 during that time period in the previous 10 years. Ralph Werner, one of the doctors involved in the study, said the numbers returned to baseline this year, possibly because the pandemic no longer seemed so frightening.
Neurologists in the United States said they were not aware of similar research in this country.
Beyond stress, transient global amnesia is associated with a strange assortment of possible triggers: sudden immersion in cold or hot water, strenuous activity, sexual intercourse, some medical procedures, and mild head trauma. It is more common in people over 50 — the average age is about 62 — and often starts in the morning. People who, like Hanson, have a history of migraines are at higher risk.
Epileptic seizures can cause shorter memory lapses called transient epileptic amnesia. While people with strokes usually have physical symptoms, as well, some with amnesia are actually having strokes, so it’s important to see a doctor. Physicians have to rule out other neurologic problems before settling on the more reassuring TGA diagnosis.
The hallmark of TGA is repeated questions. What am I doing here? Where was I going? This may sound a lot like dementia, but dementia patients have broader problems with their thinking that develop gradually. People with TGA know their names and their addresses. They can still competently perform such skills as driving a car, hitting a golf ball, cooking or doing math problems. They just can’t remember what happened a few minutes ago.
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